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Articles » Cardiovascular » Transposition of great arteries

2006-07-17-16 Double cardiac discordance © Cuillier

Corrected transposition of the great arteries

Cuillier F, MD,* Bideault J, MD**, David N, MD***

* Department of Gynecology, Felix Guyon Hospital  ** Department of Obstetrics, Hospital intercommunal de Sain Benoit ***Pediatric CardioSonographer, Ile de la Reunion, France

A 30-year-old-woman, G2P1, was referred to our service because of a suspicion of a cardiac anomaly. The nuchal translucency and the triple test were normal. At 28 weeks, a cardiac anomaly was diagnosed. The patient was sent to us at 32 weeks.

The four-chamber view showed a large right-sided ventricle, with a morphologic left ventricular appearance. The right atrium was connected to this right-sided left ventricle (with systemic connections). A morphologic right ventricle (left-sided) was connected to a small left atrium.  The forman ovale flap was seen on the left side.  The aorta connected to the left-sided, morphologic right ventricle. The pulmonary artery seemed connected to the right-sided morphologic left ventricle. The diameter of the aorta was 7 mm. The pulmonary artery measured 6 mm. A normal sinus rhythm was present. There was situs solitus.

The diagnosis of congenitally corrected transposition of the great arteries was suspected. Pulsed Doppler did not show any mitral or tricuspid regurgitation. At 31 weeks, a karyotype was performed (46 XY). At 35 weeks, the biometry was appropriate for the gestational age. There were no associated anomalies. At 38 weeks, a cesarean was performed (3580 g). The baby tolerated this well. A postnatal scan confirmed the diagnosis of a congenitally corrected transposition of the great arteries. At six months of life, the baby is in good health.


Note the right ventricle on the left side and the left ventricle on the right side

Note the aorta and the pulmonary artery. The aorta arises from the left side (morphologic right ventricle). The pulmonary arises from the right side (morphologic left ventricle)

Note the normal diameter of the great arteries